title: Occurrence of Guillain-Barré syndrome as an immune mediated complication after thrombolysis with streptokinase for acute anterior wall myocardial infarction: a caution to be vigilant.
abstract: Guillain-Barré syndrome (GBS) constitutes a heterogeneous group of immune-mediated peripheral neuropathic disorders that can be triggered by a variety of antecedent events. Clinical symptoms are thought to result from streptokinase antibody-mediated damage to the local blood-nerve barrier. We report the case of a 50-year-old man with acute anterior wall myocardial infarction who developed GBS as a manifestation of autoimmune hypersensitivity reaction to the drug 17 days after thrombolytic therapy with streptokinase. The patient was treated with a 5-day course of intravenous γ globulin and his symptoms improved and there was no residual deficit. The case forms a reminder of the autoimmune complications of non-fibrin specific agents that can sometimes be catastrophic and require persistent and vigilant in-hospital and immediate postdischarge follow-up and immediate management.
authors.affiliation: Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, India.
authors.forename: Basant
authors.initials: B
authors.lastname: Kumar
authors.forename: Navin
authors.initials: N
authors.lastname: Agrawal
authors.forename: Soumya
authors.initials: S
authors.lastname: Patra
authors.forename: C N
authors.initials: CN
authors.lastname: Manjunath
mesh_terms: D056988:Anterior Wall Myocardial Infarction / Q000188:drug therapy*; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D020275:Guillain-Barre Syndrome / Q000139:chemically induced* / Q000276:immunology; D006801:Humans; D007116:Immunization, Passive; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D013300:Streptokinase / Q000009:adverse effects*; D005719:gamma-Globulins / Q000627:therapeutic use
chemical_list: D005343:Fibrinolytic Agents; D007155:Immunologic Factors; D005719:gamma-Globulins; D013300:Streptokinase